Crohn Disease Treatment Algorithm

Crohn Disease Treatment Algorithm - Flowchart Crohn Disease Crohn Disease

«Flowchart»

Start

UGI disease

UGI disease UGI disease

Ileitis

Ileitis Ileitis

Ileocolitis/colitis

Ileocolitis/colitis Ileocolitis/colitis

Perianal disease

Perianal disease Perianal disease

Fistulizing disease^*

Fistulizing disease^* ^* * Fistulizing disease

Mild to moderate
Extended release
Budesonide^†

Mild to moderate Mild to moderate
Extended release
Budesonide^† ^† †

Mild to moderate
Extended release
Budesonide

Mild to moderate Mild to moderate
Extended release
Budesonide

Mild to moderate
Immunomodulator
Anti–TNF- agents
Ustekinumab
Vedolizumab

Mild to moderate Mild to moderate
Immunomodulator
Anti–TNF- agents
Ustekinumab
Vedolizumab

Mild to moderate
Immunomodulator
Anti–TNF- agents
Antibiotics^**

Mild to moderate Mild to moderate
Immunomodulator
Anti–TNF- agents
Antibiotics^** ^** **

Mild to moderate
Immunomodulator
Anti–TNF- agents
Antibiotics

Mild to moderate Mild to moderate
Immunomodulator
Anti–TNF- agents
Antibiotics

Moderate to severe

Corticosteroids induction
Immunomodulator: Anti–TNF- agents, vedolizumab, tofacitinib, natalizumab, ustekinumab
Supportive therapy for induction (NPO, TPN)

Moderate to severe

Corticosteroids induction
Immunomodulator: Anti–TNF- agents, vedolizumab, tofacitinib, natalizumab, ustekinumab
Supportive therapy for induction (NPO, TPN)

Moderate to severe

Corticosteroids induction
Immunomodulator: Anti–TNF- agents, vedolizumab, tofacitinib, natalizumab, ustekinumab
Supportive therapy for induction (NPO, TPN)

Refractory to medical therapy or perforation surgery

End

Moderate to severe

Temporary diversion surgery
Supportive therapy for
induction (NPO, TPN)

Moderate to severe

Temporary diversion surgery
Supportive therapy for
induction (NPO, TPN)

Moderate to severe
Moderate to severe

Temporary diversion surgery
Supportive therapy for
induction (NPO, TPN)

Temporary diversion surgery
Supportive therapy for
induction (NPO, TPN)
Persistent fistula

Temporary diversion surgery
Supportive therapy for induction (NPO, TPN)

Persistent fistula

Temporary diversion surgery
Supportive therapy for induction (NPO, TPN)

Persistent fistula
Persistent fistula

Temporary diversion surgery
Supportive therapy for induction (NPO, TPN)

Temporary diversion surgery
Supportive therapy for induction (NPO, TPN)
^*Abscess should be excluded before initiating medical therapy

^*Abscess should be excluded before initiating medical therapy

^*Abscess should be excluded before initiating medical therapy
^*
^†Proximal colon disease involvement.

^†Proximal colon disease involvement.

^†Proximal colon disease involvement.
^†
^**Perianal location.

^**Perianal location.

^**Perianal location.
^**